Alec Baldwin has apologized to a New York City-based lesbian, gay, bisexual, and transgender rights group for a series of tweets that could be interpreted as homophobic.
Baldwin?s messages were directed at a newspaper reporter who accused his wife of tweeting during the funeral for former Sopranos star James Gandolfini. Baldwin says in a letter to GLAAD posted on its website Friday his tweets didn?t have anything to do with ?issues of anyone?s sexual orientation.?
The former 30 Rock star says he?s done political work with marriage equality groups and insists he wouldn?t advocate violence against someone for being gay.
GLAAD spokesman Rich Ferraro says Baldwin?s language was improper and his tweets didn?t reflect his ?history of actively supporting LGBT equality.?
Read more: After another expletive-filled rant, Alec Baldwin begs off Twitter ? again On the scene: Family, friends, and fans remember James Gandolfini at Manhattan funeral Alec Baldwin blasts government for cutting corners, trading freedom for security
The Federal Communications Commission has finally voted to open up 10MHz of spectrum for "commercial mobile services"?that has until now been protected because of interference concerns.
The spectrum block, sitting between 1915-1920MHz and 1995-2000MHz, is called the H block and could be ready for use as soon as early 2014. Previously the FCC has kept the spectrum clear because of concerns about interference with a nearby Personal Communication Service block.
In some desperation, the FCC decided to set up a series of technical rules to stop the H block from interfering with PCS signals. As a result, it's now ready to be auctioned off. The good news is that more spectrum means better mobile data?or at least, mobile data that doesn't get slower with time. [PC World]
Google Now is getting two new cards today: Offers and TV. Offers will notify you when you're near a store that you've saved an offer for, while the latter works like Shazam but for IMDB-like content. You'd think it would tell you when shows are on, but it doesn't. Oh well. [Google]
AMMAN, Jordan (AP) ? Secretary of State John Kerry plunged back into the decades-long Israeli-Palestinian conflict on Thursday, using Jordan as a base for talks with Israeli Prime Minister Benjamin Netanyahu and Palestinian President Mahmoud Abbas.
In is fifth visit to the region to try to restart peace talks, Kerry held a four-hour dinner meeting with Netanyahu that stretched into Friday morning. He was to have lunch with Abbas on Friday in Amman, and more meetings could be in the offing.
Kerry left Amman on Thursday evening in a convoy of nearly a dozen vehicles for the roughly 90-minute drive to Jerusalem. A Jordanian military helicopter flew over his convoy during the trip, according to a reporter who was allowed to make the trip with Kerry and his delegation.
Netanyahu was about an hour late, apparently telling Kerry that he was delayed because he had been attending a graduation ceremony for Israeli military pilots. They started talking around 9:30 p.m. local time in a suite at a hotel in Jerusalem and ended their discussion around 1:30 a.m. Friday.
There were no immediate readouts of the discussion from Israeli or U.S. officials.
U.S. State department officials say that while there are no scheduled plans for any three-way discussion during Kerry's trip, they are confident that both sides are open to negotiations, or at least sitting down together at the same table to restart talks that broke down in 2008.
Kerry, they say, will continue to try to find common ground between the two sides that would lead to a re-launching of peace talks. On this trip, Kerry is trying to pin down precisely what conditions Abbas and Netanyahu have for restarting talks and perhaps discuss confidence-building measures.
Beyond that, Kerry wants to talk about the positive outcomes, such as enhanced economic growth, of a two-state solution. But at the same time, the secretary, who has long-time relationships with officials from both sides, will remind them of what's at stake if the conflict is left unresolved, they said.
Earlier this month, in a speech to the American Jewish Committee Global Forum in Washington, Kerry warned of serious consequences if no deal is reached.
"Think about what could happen next door," he told the Jewish audience. " The Palestinian Authority has committed itself to a policy of nonviolence. ... Up until recently, not one Israeli died from anything that happened from the West Bank until there was a settler killed about a month ago.
"But if that experiment is allowed to fail, ask yourselves: What will replace it? What will happen if the Palestinian economy implodes, if the Palestinian Security Forces dissolve, if the Palestinian Authority fails? ... The failure of the moderate Palestinian leadership could very well invite the rise of the very thing that we want to avoid: the same extremism in the West Bank that we have seen in Gaza or from southern Lebanon."
So far, there have been no public signals that the two sides are narrowing their differences.
Abbas has said he won't negotiate unless Israel stops building settlements on war-won lands or accepts its 1967 lines ? before the capture of the West Bank, Gaza Strip and east Jerusalem in a Mideast war that year ? as a starting point for border talks. The Palestinians claim all three areas for their future state.
Netanyahu has rejected the Palestinian demands, saying there should be no pre-conditions ? though his predecessor conducted talks on the basis of the pre-1967 lines, and the international community views the settlements as illegal or illegitimate.
Earlier on Thursday, Kerry talked about the crisis in Syria and the Mideast peace process over lunch with Jordan's King Abdullah II.
In a statement, the Royal Palace said Abdullah told Kerry that he will continue trying to bridge the gaps in the viewpoints of Palestinians and Israelis. But he warned that Israel's "unilateral actions, which include continuous Israeli trespassing on Christian and Muslim holy sites, undermine chances for peace."
On Wednesday, an Israeli planning committee gave the final approval for construction of dozens of new homes in a settlement in east Jerusalem. The announcement, which was made the day before Kerry's visit, appeared to be an Israeli snub at the secretary of state's latest round of Mideast diplomacy.
Officials traveling with Kerry sought to minimize the significance of the announcement, saying the U.S. has repeatedly said that continued construction of settlements were unhelpful to efforts to restart the talks. The settlements are part of the Har Homa area of east Jerusalem. The Obama administration said it was "deeply concerned" back in 2011 when an Israeli planning commission approved 930 new housing units in the Har Homa neighborhood.
The Palestinian side condemned the announcement.
"Such behavior proves that the Israeli government is determined to undermine Secretary Kerry's efforts at every level," said Palestinian negotiator Saeb Erekat.
___
Associated Press writer Jamal Halaby in Amman contributed to this report.
June 27, 2013 ? Non-invasive brain stimulation may help stroke survivors recover speech and language function, according to new research in the American Heart Association journal Stroke.
Between 20 percent to 30 percent of stroke survivors have aphasia, a disorder that affects the ability to grasp language, read, write or speak. It's most often caused by strokes that occur in areas of the brain that control speech and language.
"For decades, skilled speech and language therapy has been the only therapeutic option for stroke survivors with aphasia," said Alexander Thiel, M.D., study lead author and associate professor of neurology and neurosurgery at McGill University in Montreal, Quebec, Canada. "We are entering exciting times where we might be able in the near future to combine speech and language therapy with non-invasive brain stimulation earlier in the recovery. This could result in earlier and more efficient aphasia recovery and also have an economic impact."
In the small study, researchers treated 24 stroke survivors with several types of aphasia at the rehabilitation hospital Rehanova and the Max-Planck-Institute for neurological research in Cologne, Germany. Thirteen received transcranial magnetic stimulation (TMS) and 11 got sham stimulation.
The TMS device is a handheld magnetic coil that delivers low intensity stimulation and elicits muscle contractions when applied over the motor cortex.
During sham stimulation the coil is placed over the top of the head in the midline where there is a large venous blood vessel and not a language-related brain region. The intensity for stimulation was lower intensity so that participants still had the same sensation on the skin but no effective electrical currents were induced in the brain tissue.
Patients received 20 minutes of TMS or sham stimulation followed by 45 minutes of speech and language therapy for 10 days.
The TMS groups' improvements were on average three times greater than the non-TMS group, researchers said. They used German language aphasia tests, which are similar to those in the United States, to measure language performance of the patients.
"TMS had the biggest impact on improvement in anomia, the inability to name objects, which is one of the most debilitating aphasia symptoms," Thiel said.
Researchers, in essence, shut down the working part of the brain so that the stroke-affected side could relearn language. "This is similar to physical rehabilitation where the unaffected limb is immobilized with a splint so that the patients must use the affected limb during the therapy session," Thiel said.
"We believe brain stimulation should be most effective early, within about five weeks after stroke, because genes controlling the recovery process are active during this time window," he said.
Thiel said the result of this study opens the door to larger, multi-center trials. The NORTHSTAR study has been funded by the Canadian Institutes of Health Research and will be launched at four Canadian sites and one German site later in 2013.
The Walter and Marga Boll and Wolf-Dieter-Heiss Foundations funded the current study.
VIENNA (Reuters) - A sharp rise in the variety of legal "designer drugs" with names that entice young people into thinking they pose no risk is alarming from a public health standpoint, the United Nations drugs agency said on Wednesday.
The number of new psychoactive substances - marketed as "designer drugs" and "legal highs" - as reported by member states jumped by more than 50 percent in less than three years to 251 by mid-2012, the U.N. Office on Drugs and Crime said.
"This is an alarming drug problem - but the drugs are legal," it said. "Sold openly, including via the Internet, NPS (new psychoactive substances), which have not been tested for safety, can be far more dangerous than traditional drugs."
Names including "spice", "meow-meow" and "bath salts" mislead young people into believing they are indulging in low-risk fun, UNODC said.
But "the adverse effects and addictive potential of most of these uncontrolled substances are at best poorly understood", the agency said in an annual survey.
Use of such substances among youth in the United States appears to be more than twice as widespread as in the 27-nation European Union, where the United Kingdom, Poland and France have the most users, it said.
New psychoactive substances can be made by slightly modifying the molecular structure of controlled drugs, making a new drug with similar effects which can elude national and international bans.
They are "proliferating at an unprecedented rate and posing unforeseen public health challenges," said the report that examines production, trafficking and consumption trends.
"The international drug control system is floundering, for the first time, under the speed and creativity of the phenomenon" of this type of substances, the UNODC report said.
HEROIN, COCAINE USE SEEMS ON WANE
Overall, global drug consumption has remained stable, the report said, referring to the number of drug users with dependence or drug-use disorders. In 2011, the number of drug-related deaths was estimated at 211,000.
"While the use of traditional drugs, such as heroin and cocaine, seems to be declining in some parts of the world, prescription drug abuse and new psychoactive substance abuse is growing," it said.
Heroin use in Europe and that of cocaine in the United States appear to be falling while the cocaine market is expanding in South America and the emerging economies in Asia.
The U.N. agency's 2013 World Drug Report also said revised data showed that the prevalence of people injecting drugs who are also infected with the human immunodeficiency virus that causes AIDS was sharply lower than previously estimated.
In 2011, about 1.6 million people between the ages of 15 and 64 who injected drugs were living with HIV, a 46 percent decline since estimates three years earlier. The overall number of people using needles to take drugs was also lower.
The reduced figures are "in large part a result of the availability of more reliable information on HIV prevalence among people who inject drugs", the report said.
Criminals have been quick to tap into the lucrative market of new psychoactive substances while the law lags behind, the U.N. office said. Africa is becoming a target for the trafficking and production of illicit substances, it added.
"East and West Africa seems to be gaining in prominence with regard to routes for maritime trafficking," the report said. Seizures of heroin have risen sharply in Africa since 2009, especially in East Africa, where they increased almost tenfold.
Google Reader is going away, but Press is here to stay and integrates perfectly with new services
When Google casually noted that it would shut down its RSS aggregation service Reader back in March, news apps that relied on it as a backbone were left scrambling. As alternative services to Google Reader such as Feedly and Feed Wrangler popped up on the scene, a few of the aforementioned apps pivoted quickly to integrate the new services. We gave one of such apps, Press, the review treatment as a Google Reader client back in December and came away extremely impressed with its design and performance.
Even though Google Reader will close its doors on July 1st, Press lives on as a fantastic RSS client that will work with (among other systems) the Feedly account you may have set up to save yourself from losing everything. The developers have made some great settings and user interface improvements along the way as well, so let's take a refreshed look at Press.
June 26, 2013 ? People who believe that stress is having an adverse impact on their health are probably right, because they have an increased risk of suffering a heart attack, according to new research published online today (Thursday) in the European Heart Journal.
The latest findings from the UK's Whitehall II study, which has followed several thousand London-based civil servants since 1985, found that people who believe stress is affecting their health "a lot or extremely" had double the risk of a heart attack compared to people who didn't believe stress was having a significant effect on their health. After adjusting for factors that could affect this result, such as biological, behavioural or psychological risk factors, they still had a 50% greater risk of suffering or dying from a heart attack.
Previous results from Whitehall II and other studies have already shown that stress can have an adverse effect on people's health, but this is the first time researchers have investigated people's perceptions of how stress is affecting their health and linked it to their risk of subsequent heart disease.
"This current analysis allows us to take account of individual differences in response to stress," said Dr Hermann Nabi, the first author of the study, who is a senior research associate at the Centre for Research in Epidemiology and Population Health at Inserm (Institut national de la sant? et de la recherche m?dicale), Villejuif, France.
Dr Nabi and his colleagues from France, Finland and the UK, followed 7268 men and women for a maximum of 18 years from 1991 when the question about perceived impact of stress on health was first introduced into the questionnaire answered by study participants. The average age of the civil servants in this analysis was 49.5 and during the 18 years of follow-up there were 352 heart attacks or deaths as a result of heart attack (myocardial infarction).
The participants were asked to what extent they felt that stress or pressure they experienced in their lives had affected their health. They could answer: "not at all," "slightly," "moderately," "a lot," or "extremely." The researchers put their answers into three groups: 1) "not at all," 2) "slightly or moderately," and 3) "a lot or extremely." The civil servants were also asked about their perceived levels of stress, as well as about other lifestyle factors that could influence their health, such as smoking, alcohol consumption, diet, and levels of physical activity. Medical information, such as blood pressure, diabetes and body mass index, and socio-demographic data, such as marital status, age, sex, ethnicity and socio-economic status, was also collected. Data from the British National Health Service enabled researchers to follow the participants for subsequent years and to see whether or not they had a heart attack or died from it by 2009.
After adjusting for socio-demographic characteristics, civil servants who reported at the beginning of the study that their health had been affected "a lot or extremely" by stress had more than double the risk (2.12 higher) of having a heart attack or dying from it compared with those who reported no effect of stress on their health. After further adjustments for biological, behavioural and other psychological risk factors, including stress levels and measures of social support, the risk was not as great, but still higher -- nearly half as much again (49% higher) -- than that seen in people who reported no effect on their health.
Dr Nabi said: "We found that the association we observed between an individual's perception of the impact of stress on their health and their risk of a heart attack was independent of biological factors, unhealthy behaviours and other psychological factors."
He added: "One of the important messages from our findings is that people's perceptions about the impact of stress on their health are likely to be correct."
The authors say that their findings have far-reaching implications. Future studies of stress should include people's perceptions of its impact on their health. From a clinical point of view, doctors should consider patients' subjective perceptions and take them into account when managing stress-related health complaints.
Dr Nabi said: "Our findings show that responses to stress or abilities to cope with stress differ greatly between individuals, depending on the resources available to them, such as social support, social activities and previous experiences of stress. Concerning the management of stress, I think that the first step is to identify the stressors or sources of stress, for example job pressures, relationship problems or financial difficulties, and then look for solutions. There are several ways to cope with stress, including relaxation techniques, physical activity, and even medications, particularly for severe cases. Finally, I think that the healthcare system has a role to play. The conclusion of a recent study conducted for the American Psychological Association tells us that health care systems are falling short on stress management, even though a significant proportion of people believe that the stress or pressure they experienced has an impact on their health."
In their conclusion, the authors write: "Although, stress, anxiety, and worry are thought to have increased in recent years, we found only participants (8%) who reported stress to have affected their health 'a lot or extremely' had an increased risk of CHD. In the future, randomized controlled trials are needed to determine whether disease risk can be reduced by increasing clinical attention to those who complain that stress greatly affects their health."
There are some limitations to the study, including the fact that it did not include blue-collar workers or the unemployed and therefore it may not be representative of the general population.
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Starting on 3 drugs at time of diagnosis benefits Type 2 diabeticsPublic release date: 24-Jun-2013 [ | E-mail | Share ]
Contact: Will Sansom Sansom@uthscsa.edu 210-567-2579 University of Texas Health Science Center at San Antonio
Therapy produced stable glucose and hemoglobin A1C readings, and weight loss
SAN ANTONIO (June 24, 2013) Patients with type 2 diabetes fare significantly better if they are started on three medications at the time of diagnosis than if they are prescribed a single drug and have other therapies added later, a San Antonio researcher said June 22 at the 73rd Scientific Sessions of the American Diabetes Association in Chicago. The findings, from a study funded by the association, could revise the way physicians manage the endocrine disease.
Comparison
UT Medicine San Antonio physician Ralph DeFronzo, M.D., chief of the Diabetes Division in the School of Medicine at The University of Texas Health Science Center at San Antonio, presented two-year results from 134 participants studied at University Health System's Texas Diabetes Institute. Half of the subjects received the triple-therapy regimen while the other half received the conventional regimen recommended by the ADA. The standard regimen begins with a single agent (metformin), adds another (sulfonylurea) when the first agent fails, and then adds insulin injections as needed to control blood glucose after the second agent fails.
Dr. DeFronzo reported that:
Mean hemoglobin A1c, a test that strongly predicts the risk of diabetic blood vessel complications such as blindness, kidney failure, heart attacks, stroke and neuropathy, was 6.0 percent after 24 months in the triple-therapy group, compared to 6.6 percent in the conventional therapy group. (The American Diabetes Association and the European Association for Study of Diabetes recommend a maximum hemoglobin A1c level of 6.5 percent.)
While 42 percent of conventional-therapy participants failed to reach the 6.5 percent goal, only 17 percent of the triple-therapy recipients failed to reach it.
In home blood glucose monitoring, triple-therapy patients showed consistent results within the normal range, whereas patients on conventional therapy registered up and down spikes, many of which were out of the normal range.
Patients on triple therapy lost 2-3 pounds on average after two years while patients on conventional therapy gained 9-10 pounds.
Fifteen percent of patients on triple therapy experienced one episode of hypoglycemia (low blood glucose), while 46 percent of those on conventional therapy had at least one hypoglycemic event.
Core deficits corrected
The triple therapy combines agents that correct two core defects in type 2 diabetes the inability to respond to insulin normally (insulin resistance), and failure of insulin-secreting beta cells to produce enough insulin. Insulin is the hormone that lowers blood glucose levels. Before the study, Dr. DeFronzo and his colleagues, including co-investigator, Muhammad Abdul-Ghani, M.D., Ph.D., of UT Medicine, hypothesized that the triple therapy would produce a greater, more durable reduction in hemoglobin A1c, reduce the fluctuation in plasma glucose by decreasing both fasting and between-meal glucose levels, and prevent weight gain, which is a side effect of traditional therapy.
Two years of normalcy
Two years into the three-year study, it is clear that the triple therapy is accomplishing these therapeutic goals, and that beta cells are being preserved and the body is being sensitized to insulin. "These drugs are not cures, but patients are basically normal while taking them," Dr. DeFronzo said. "They are not going to develop the microvascular (blood vessel) complications as long as their blood glucose level remains within the normal range."
3 drugs, 3 mechanisms
The triple therapy consists of metformin, a drug that Dr. DeFronzo helped develop in the 1990s; pioglitazone, a newer class of medication for type 2 diabetes; and exenatide, another newer class of drug. Each drug works by a different mechanism, Dr. DeFronzo said. Conventional therapy is to start the patient on metformin and when the response stops, add a class of medication called a sulfonylurea. When those no longer work, the patient is placed on insulin.
Factors for patients, doctors to weigh
Problems with the conventional approach include weight gain, episodes of hypoglycemia and failure to prevent beta cell failure. The conventional approach is less expensive, however.
"We should tell people which drugs work better," Dr. DeFronzo said. "The individuals and doctors need to decide whether they can afford the treatment."
Failure at 10 years out
According to the United Kingdom Prospective Diabetes Study, patients on conventional therapy had an average hemoglobin A1c level of 8.6 percent after a mean of 10 years of follow-up, and nearly two-thirds (65 percent) were on insulin for glucose control.
The Texas Diabetes Institute, a program of University Health System, is the nation's largest and most comprehensive center, entirely devoted to diabetes prevention, treatment, education, professional training and the relentless search for a cure. Texas Diabetes Institute is located where it is most needed, on San Antonio's West Side, where the incidence of diabetes is the highest in the nation.
###
For current news from the UT Health Science Center San Antonio, please visit our news release website, like us on Facebook or follow us on Twitter.
About UT Medicine San Antonio
UT Medicine San Antonio is the clinical practice of the School of Medicine at the UT Health Science Center San Antonio. With more than 700 doctors all School of Medicine faculty UT Medicine is the largest medical practice in Central and South Texas. Expertise is in more than 100 medical specialties and subspecialties. Primary care doctors and specialists see patients in private practice at UT Medicine's flagship clinical home, the Medical Arts & Research Center (MARC), located at 8300 Floyd Curl Drive, San Antonio 78229. Most major health plans are accepted, and UT Medicine physicians also practice at several local and regional hospitals. Call (210) 450-9000 to schedule an appointment, or visit http://www.UTMedicine.org for a list of clinics and phone numbers.
About University Health System
University Health System is a nationally recognized academic medical center and network of outpatient health centers, owned by the taxpayers of Bexar County. University Health System is consistently recognized as a leader for going paperless with electronic medical records and is the first public health system in Texas to be designated as Magnet Hospital by the American Nurses Credentialing Center. University Hospital, its 496-bed acute care hospital, is the primary teaching hospital for the University of Texas Health Science Center San Antonio, consistently named Best Regional Hospital U.S. News & World Report and is one of just 15 Level I trauma centers in Texas. University Health System's Community First Health Plans is the region's only locally-owned, nonprofit HMO and San Antonio AirLIFE, jointly owned by University Health System, is a national leader in emergency air medical transport. For more, please go online at UniversityHealthSystem.com.
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Starting on 3 drugs at time of diagnosis benefits Type 2 diabeticsPublic release date: 24-Jun-2013 [ | E-mail | Share ]
Contact: Will Sansom Sansom@uthscsa.edu 210-567-2579 University of Texas Health Science Center at San Antonio
Therapy produced stable glucose and hemoglobin A1C readings, and weight loss
SAN ANTONIO (June 24, 2013) Patients with type 2 diabetes fare significantly better if they are started on three medications at the time of diagnosis than if they are prescribed a single drug and have other therapies added later, a San Antonio researcher said June 22 at the 73rd Scientific Sessions of the American Diabetes Association in Chicago. The findings, from a study funded by the association, could revise the way physicians manage the endocrine disease.
Comparison
UT Medicine San Antonio physician Ralph DeFronzo, M.D., chief of the Diabetes Division in the School of Medicine at The University of Texas Health Science Center at San Antonio, presented two-year results from 134 participants studied at University Health System's Texas Diabetes Institute. Half of the subjects received the triple-therapy regimen while the other half received the conventional regimen recommended by the ADA. The standard regimen begins with a single agent (metformin), adds another (sulfonylurea) when the first agent fails, and then adds insulin injections as needed to control blood glucose after the second agent fails.
Dr. DeFronzo reported that:
Mean hemoglobin A1c, a test that strongly predicts the risk of diabetic blood vessel complications such as blindness, kidney failure, heart attacks, stroke and neuropathy, was 6.0 percent after 24 months in the triple-therapy group, compared to 6.6 percent in the conventional therapy group. (The American Diabetes Association and the European Association for Study of Diabetes recommend a maximum hemoglobin A1c level of 6.5 percent.)
While 42 percent of conventional-therapy participants failed to reach the 6.5 percent goal, only 17 percent of the triple-therapy recipients failed to reach it.
In home blood glucose monitoring, triple-therapy patients showed consistent results within the normal range, whereas patients on conventional therapy registered up and down spikes, many of which were out of the normal range.
Patients on triple therapy lost 2-3 pounds on average after two years while patients on conventional therapy gained 9-10 pounds.
Fifteen percent of patients on triple therapy experienced one episode of hypoglycemia (low blood glucose), while 46 percent of those on conventional therapy had at least one hypoglycemic event.
Core deficits corrected
The triple therapy combines agents that correct two core defects in type 2 diabetes the inability to respond to insulin normally (insulin resistance), and failure of insulin-secreting beta cells to produce enough insulin. Insulin is the hormone that lowers blood glucose levels. Before the study, Dr. DeFronzo and his colleagues, including co-investigator, Muhammad Abdul-Ghani, M.D., Ph.D., of UT Medicine, hypothesized that the triple therapy would produce a greater, more durable reduction in hemoglobin A1c, reduce the fluctuation in plasma glucose by decreasing both fasting and between-meal glucose levels, and prevent weight gain, which is a side effect of traditional therapy.
Two years of normalcy
Two years into the three-year study, it is clear that the triple therapy is accomplishing these therapeutic goals, and that beta cells are being preserved and the body is being sensitized to insulin. "These drugs are not cures, but patients are basically normal while taking them," Dr. DeFronzo said. "They are not going to develop the microvascular (blood vessel) complications as long as their blood glucose level remains within the normal range."
3 drugs, 3 mechanisms
The triple therapy consists of metformin, a drug that Dr. DeFronzo helped develop in the 1990s; pioglitazone, a newer class of medication for type 2 diabetes; and exenatide, another newer class of drug. Each drug works by a different mechanism, Dr. DeFronzo said. Conventional therapy is to start the patient on metformin and when the response stops, add a class of medication called a sulfonylurea. When those no longer work, the patient is placed on insulin.
Factors for patients, doctors to weigh
Problems with the conventional approach include weight gain, episodes of hypoglycemia and failure to prevent beta cell failure. The conventional approach is less expensive, however.
"We should tell people which drugs work better," Dr. DeFronzo said. "The individuals and doctors need to decide whether they can afford the treatment."
Failure at 10 years out
According to the United Kingdom Prospective Diabetes Study, patients on conventional therapy had an average hemoglobin A1c level of 8.6 percent after a mean of 10 years of follow-up, and nearly two-thirds (65 percent) were on insulin for glucose control.
The Texas Diabetes Institute, a program of University Health System, is the nation's largest and most comprehensive center, entirely devoted to diabetes prevention, treatment, education, professional training and the relentless search for a cure. Texas Diabetes Institute is located where it is most needed, on San Antonio's West Side, where the incidence of diabetes is the highest in the nation.
###
For current news from the UT Health Science Center San Antonio, please visit our news release website, like us on Facebook or follow us on Twitter.
About UT Medicine San Antonio
UT Medicine San Antonio is the clinical practice of the School of Medicine at the UT Health Science Center San Antonio. With more than 700 doctors all School of Medicine faculty UT Medicine is the largest medical practice in Central and South Texas. Expertise is in more than 100 medical specialties and subspecialties. Primary care doctors and specialists see patients in private practice at UT Medicine's flagship clinical home, the Medical Arts & Research Center (MARC), located at 8300 Floyd Curl Drive, San Antonio 78229. Most major health plans are accepted, and UT Medicine physicians also practice at several local and regional hospitals. Call (210) 450-9000 to schedule an appointment, or visit http://www.UTMedicine.org for a list of clinics and phone numbers.
About University Health System
University Health System is a nationally recognized academic medical center and network of outpatient health centers, owned by the taxpayers of Bexar County. University Health System is consistently recognized as a leader for going paperless with electronic medical records and is the first public health system in Texas to be designated as Magnet Hospital by the American Nurses Credentialing Center. University Hospital, its 496-bed acute care hospital, is the primary teaching hospital for the University of Texas Health Science Center San Antonio, consistently named Best Regional Hospital U.S. News & World Report and is one of just 15 Level I trauma centers in Texas. University Health System's Community First Health Plans is the region's only locally-owned, nonprofit HMO and San Antonio AirLIFE, jointly owned by University Health System, is a national leader in emergency air medical transport. For more, please go online at UniversityHealthSystem.com.
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AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert! system.
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